MICHAEL G MCMANNIS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****94

License Status

NOT RENEWED

Business

First Name

MICHAEL G

Last Name

MCMANNIS

Business Name

MICHAEL G MCMANNIS

Original Issue Date

11/14/1996

Effective Date

11/14/1996

Expiration Date

09/30/2000

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005